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Phelan S, Tseng M, Kelleher A, Kim E, Macedo C, Charbonneau V, Gilbert I, Parro D, Rawlings L. Increasing Access to Medical Care for Hispanic Women Without Insurance: A Mobile Clinic Approach. J Immigr Minor Health 2024; 26:482-491. [PMID: 38170427 DOI: 10.1007/s10903-023-01575-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
The purpose of this study was to describe the health status and barriers of people who sought care on a free mobile health clinic for women without insurance in California. Participants were 221 women who attended the Salud para Mujeres (Women's Health) mobile medical clinic between 2019 and 2021. Medical chart abstractions provided data on sociodemographic factors, medical history, barriers to care, depressive symptoms, and dietary factors. Anthropometric measure, blood pressure, and biomarkers of cardiometabolic disease risk were also abstracted. Participants were young adult (29.1 [SD 9.3] years), Hispanic (97.6%), farm-working (62.2%) women from Mexico (87.0%). Prevalent barriers to accessing (non-mobile) medical care included high cost (74.5%), language (47.6%), hours of operation (36.2%), and transportation (31.4%). The majority (89.5%) of patients had overweight (34.0%) or obesity (55.5%), and 27% had hypertension. Among those (n = 127) receiving a lipid panel, 60.3% had higher than recommended levels of low-density lipoprotein and 89% had lower than recommended levels of high-density lipoprotein. Point-of-care HbA1c tests (n = 133) indicated that 9.0% had diabetes and 24.8% had prediabetes. Over half (53.1%) of patients reported prevalent occupational exposure to pesticides and 19% had moderate to severe depressive symptoms. Weekly or more frequent consumption of sugar sweetened beverages (70.9%) and fast food (43.5%) were also prevalent. Mobile health units have potential for reaching women who face several barriers to care and experience major risk factors for cardometabolic disease. Findings suggest a compelling need to assure that Hispanic and Indigenous women and farmworkers have access to healthcare.
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Affiliation(s)
- Suzanne Phelan
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA.
| | - Marilyn Tseng
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Anita Kelleher
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Erin Kim
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Cristina Macedo
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Vicki Charbonneau
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - David Parro
- SLO NOOR Foundation, San Luis Obispo, CA, USA
| | - Luke Rawlings
- Marian Regional Medical Center, Santa Maria, CA, USA
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Aye TS, Jirapongsuwan A, Siri S. Pesticide safety behaviours among agricultural workers and farmers: A cross-sectional study. Int J Nurs Pract 2024; 30:e13222. [PMID: 38097357 DOI: 10.1111/ijn.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 06/06/2024]
Abstract
AIM The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. BACKGROUND Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. METHODS The cross-sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE-PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. RESULTS Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co-workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. CONCLUSION Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders.
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Affiliation(s)
- Thant Sin Aye
- Faculty of Public Health, Mahidol University, Nakhon Pathom, Thailand
| | - Ann Jirapongsuwan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Nakhon Pathom, Thailand
| | - Sukhontha Siri
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Nakhon Pathom, Thailand
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Ssekkadde P, Tomberge VMJ, Brugger C, Atuhaire A, Dalvie MA, Rother HA, Röösli M, Inauen J, Fuhrimann S. Evaluating and Enhancing an Educational Intervention to Reduce Smallholder Farmers' Exposure to Pesticides in Uganda Through a Digital, Systematic Approach to Behavior Change: Protocol for a Cluster-Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55238. [PMID: 38718387 PMCID: PMC11112482 DOI: 10.2196/55238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/17/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Smallholder farmers receive educational interventions on safe pesticide handling by governmental agencies, industries, or nongovernmental organizations to reduce exposure risks. However, existing educational interventions have limited effects on changing behaviors. Targeting psychosocial determinants of behavior change in educational interventions through theory- and evidence-based approaches may enhance their effectiveness. OBJECTIVE We aim at describing the intervention development and study design of a 3-arm cluster-randomized controlled trial to assess the effects in improving safe pesticide handling and reducing pesticide exposure of (1) an existing educational intervention and (2) a newly developed SMS text messaging intervention based on the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) behavior change approach. METHODS We enrolled 539 Ugandan smallholder farmers in 12 clusters (subcounties). The clusters, each with 45 farmers, were randomly allocated to one of the three arms: (1) educational intervention, (2) educational intervention+RANAS-based SMS text messages, or (3) control group. The educational intervention comprised a 2-day workshop that targeted multiple aspects of safe pesticide handling, whereas the SMS text messages targeted the use of personal protective equipment (PPE) and were based on the RANAS approach. For intervention development in this study, this approach includes identifying psychosocial determinants of PPE use at baseline and selecting behavior change techniques to target them in SMS text messages. The primary outcomes of the study are (1) pesticide knowledge, attitude, and practice scores indicating performance throughout the educational intervention; and (2) frequency of PPE use. Secondary outcomes are the RANAS-based behavioral determinants of PPE use, the frequency of glove use, algorithm-based pesticide exposure intensity scores, and signs and symptoms of pesticide poisoning. The outcomes were assessed in structured interviews before the intervention (baseline) and at the 12-month follow-up. The effect of the interventions among the arms will be analyzed using the intervention arms and baseline measures as predictors and the follow-up measures as outcomes in linear multivariable mixed models including the clusters as random effects. The mediating psychosocial determinants of the interventions will be assessed in multiple mediation models. RESULTS The study was conducted from 2020 to 2021-baseline interviews were conducted in October 2020, and the educational intervention was delivered in November 2020. The RANAS-based SMS text messages were developed based on the baseline data for relevant behavioral determinants of PPE use and sent between February 2021 and September 2021. Follow-up interviews were conducted in October 2021. Overall, 539 farmers were enrolled in the study at baseline; 8.3% (45/539) were lost to follow-up by the end of the study. CONCLUSIONS This study will contribute to a better understanding of the effectiveness and behavior change mechanisms of educational interventions by using an experimental, cluster-randomized study design to improve pesticide handling among smallholder farmers. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) 18237656; https://doi.org/10.1186/ISRCTN18237656. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55238.
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Affiliation(s)
- Peter Ssekkadde
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Vica Marie Jelena Tomberge
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Curdin Brugger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Aggrey Atuhaire
- Uganda National Association of Community and Occupational Health, Kampala, Uganda
| | - Mohamed Aqiel Dalvie
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Hanna-Andrea Rother
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Inauen
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Samuel Fuhrimann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Fei Q, Liu C, Luo Y, Chen H, Ma F, Xu S, Wu W. Rational design, synthesis, and antimicrobial evaluation of novel 1,2,4-trizaole-substituted 1,3,4-oxadiazole derivatives with a dual thioether moiety. Mol Divers 2024:10.1007/s11030-024-10848-2. [PMID: 38687400 DOI: 10.1007/s11030-024-10848-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/12/2024] [Indexed: 05/02/2024]
Abstract
In this paper, a series of novel 1,2,4-trizaole-substituted 1,3,4-oxadiazole derivatives with a dual thioether moiety were constructed. The synthetic compounds were characterized by 1H NMR, 13C NMR, HRMS, and single crystal diffraction. The antimicrobial activities of title compounds against fungi (Pyricutaria oryzae Cav., Phomopsis sp., Botryosphaeria dothidea, cucumber Botrytis cinerea, tobacco Botrytis cinerea, blueberry Botrytis cinerea) and bacteria (Xanthomonas oryzae pv. oryzicola, Xoc; Xanthomonas axonopodis pv. citri, Xac) revealed these compounds possessed excellent antibacterial activity through mycelial growth rate method and turbidity method, respectively. Among them, compounds 7a, 7d, 7g, 7k, 7l, and 7n had the antibacterial inhibition rate of 90.68, 97.86, 93.61, 97.70, 97.26, and 92.34%, respectively. The EC50 values of 7a, 7d, 7g, 7k, 7l, and 7n were 58.31, 48.76, 58.50, 40.11, 38.15, and 46.99 μg/mL, separately, superior to that of positive control pesticide thiodiazole copper (104.26 μg/mL). The molecular docking simulation of compound 7l and glutathione s-transferase also confirmed its good activity. The in vivo bioassay toward Xac infected citrus leaves was also performed to evaluate the potential of compounds as efficient antibacterial reagent. Further study of antibacterial mechanism was also carried out, including extracellular polysaccharide production, permeability of bacterial membrane, and scanning electron microscope observations. The excellent antibacterial activities of these compounds provided a strong support for its application for preventing and control plant diseases.
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Affiliation(s)
- Qiang Fei
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China
| | - Chunyi Liu
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China
| | - Yanbi Luo
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China
| | - Haijiang Chen
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China.
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China.
| | - Fengwei Ma
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China
| | - Su Xu
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China.
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China.
| | - Wenneng Wu
- Guizhou Engineering Research Center for Characteristic Flavor Perception and Quality Control of Drug-Food Homologous Resources, Guiyang University, Guiyang, 550005, People's Republic of China.
- School of Food Science and Engineering, Guiyang University, Guiyang, 550005, People's Republic of China.
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Abstract
Ubiquitous environmental exposures increase cardiovascular disease risk via diverse mechanisms. This review examines personal strategies to minimize this risk. With regard to fine particulate air pollution exposure, evidence exists to recommend the use of portable air cleaners and avoidance of outdoor activity during periods of poor air quality. Other evidence may support physical activity, dietary modification, omega-3 fatty acid supplementation, and indoor and in-vehicle air conditioning as viable strategies to minimize adverse health effects. There is currently insufficient data to recommend specific personal approaches to reduce the adverse cardiovascular effects of noise pollution. Public health advisories for periods of extreme heat or cold should be observed, with limited evidence supporting a warm ambient home temperature and physical activity as strategies to limit the cardiovascular harms of temperature extremes. Perfluoroalkyl and polyfluoroalkyl substance exposure can be reduced by avoiding contact with perfluoroalkyl and polyfluoroalkyl substance-containing materials; blood or plasma donation and cholestyramine may reduce total body stores of perfluoroalkyl and polyfluoroalkyl substances. However, the cardiovascular impact of these interventions has not been examined. Limited utilization of pesticides and safe handling during use should be encouraged. Finally, vasculotoxic metal exposure can be decreased by using portable air cleaners, home water filtration, and awareness of potential contaminants in ground spices. Chelation therapy reduces physiological stores of vasculotoxic metals and may be effective for the secondary prevention of cardiovascular disease.
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Affiliation(s)
- Luke J Bonanni
- Grossman School of Medicine (L.J.B.), NYU Langone Health, New York, NY
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Kangavari M, Sarvi M, Afshari M, Maleki S. Understanding determinants related to farmers' protective measures towards pesticide exposure: A systematic review. PLoS One 2024; 19:e0298450. [PMID: 38359033 PMCID: PMC10868758 DOI: 10.1371/journal.pone.0298450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers. METHODS In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies. RESULTS A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair. CONCLUSIONS Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.
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Affiliation(s)
- Mehdi Kangavari
- Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Sarvi
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Afshari
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahnaz Maleki
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Frengidou E, Galanis P, Malesios C. Pesticide Exposure or Pesticide Poisoning and the Risk of Depression in Agricultural Populations: A Systematic Review and Meta-Analysis. J Agromedicine 2024; 29:91-105. [PMID: 37937800 DOI: 10.1080/1059924x.2023.2278801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023]
Abstract
Evidence suggests that farm workers represent a high-risk population for the development of depression. The aim of the study was to clarify the association between pesticide exposure/poisoning and depression. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis were conducted in this systematic review and meta-analysis. Relevant studies were included through searching in PubMed, Scopus, Web of Science, ProQuest, CINAHL and pre-print services databases. A total of eight studies were included. A positive but non-significant association was observed between pesticide use and depression (OR = 1.123; 95% CI, 0.932-1.354, p-value = .221) while a significant positive association was observed between pesticide poisoning and depression (OR = 2.942; 95% CI, 1.791-4.831, p-value < .001). The present meta-analysis suggested clearly a significant positive association between pesticide poisoning and depression, confirming the hypothesis that pesticide poisoning is a risk factor of depression. It also revealed positive, yet non-significant association, between pesticide exposure and depression, a finding that enhances recent research but requires to be further supported by future cohort studies, including socioeconomic factors and biomarkers of depression.
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Affiliation(s)
- Elisavet Frengidou
- Public Organization for Providing Health Care Services, Regional Department of North and East Greece, Thessaloniki, Greece
| | - Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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Cancino J, Soto K, Tapia J, Muñoz-Quezada MT, Lucero B, Contreras C, Moreno J. Occupational exposure to pesticides and symptoms of depression in agricultural workers. A systematic review. ENVIRONMENTAL RESEARCH 2023; 231:116190. [PMID: 37217130 DOI: 10.1016/j.envres.2023.116190] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND The use of pesticides can result in harm to both the environment and human health. There is a growing concern in the field of occupational health about the impact on the mental health of agricultural workers. OBJECTIVES The objective of this review was to systematize scientific evidence from the last ten years on the impact of occupational exposure to pesticides on the development of depression symptoms in agricultural workers. METHODS We conducted a comprehensive search in the PubMed and Scopus databases from 2011 to September 2022. Our search included studies in English, Spanish, and Portuguese that examined the association between occupational exposure to pesticides and symptoms of depression in agricultural workers, following the guidelines recommended by the PRISMA statement and the PECO strategy (Population, Exposure, Comparison, and Outcomes). RESULTS Among the 27 articles reviewed, 78% of them indicated a link between exposure to pesticides and the incidence of depression symptoms. The pesticides most frequently reported in the studies were organophosphates (17 studies), herbicides (12 studies), and pyrethroids (11 studies). The majority of the studies were rated as having intermediate to intermediate-high quality, with the use of standardized measures to assess both exposure and effect. CONCLUSION The updated evidence presented in our review indicates a clear association between pesticide exposure and the development of depressive symptoms. However, more high-quality longitudinal studies are necessary to control for sociocultural variables and utilize pesticide-specific biomarkers and biomarkers of depression. Given the increased use of these chemicals and the health risks associated with depression, it is crucial to implement more stringent measures to monitor the mental health of agricultural workers regularly exposed to pesticides and to enhance surveillance of companies that apply these chemicals.
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Affiliation(s)
- Javier Cancino
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Karly Soto
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Joaquín Tapia
- School of Psychology, Faculty of Health Sciences, Universidad Católica del Maule, Chile; The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - María Teresa Muñoz-Quezada
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.
| | - Boris Lucero
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Caterina Contreras
- The Neuropsychology and Cognitive Neurosciences Research Center CINPSI Neurocog, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
| | - Jaime Moreno
- Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
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Surendran A, McSharry J, Meade O, Bligh F, McNamara J, Meredith D, O’Hora D. Increasing Machine-Related Safety on Farms: Development of an Intervention Using the Behaviour Change Wheel Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5394. [PMID: 37048009 PMCID: PMC10093886 DOI: 10.3390/ijerph20075394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
Farming is essential work, but it suffers from very high injury and fatality rates. Machinery, including tractors, are a leading cause of serious injuries and fatalities to farmers and farm workers in many countries. Herein, we document the systematic development of an evidence-based, theory-informed behaviour change intervention to increase machine-related safety on farms. Intervention development progressed through four phases. Phase 1 defined the problem in behavioural terms based a review of the literature, Phase 2 identified candidate intervention targets through a series of focus groups guided by the Capability-Opportunity-Motivation-Behaviour (COM-B) model and Phase 3 employed expert and stakeholder consultation guided by the Behaviour Change Wheel (BCW) to consider potential target behaviours and intervention components and finalise the intervention content. Phase 4 finalised the evaluation strategies with a team of agricultural advisors who supported the rollout and identified outcome measures for the first trial. The target intervention was the identification of blind spots of farm tractors, and three priority target behaviours (farm safety practices) were identified. Following Phase 3, the intervention comprised four components that are delivered in a group-based, face-to-face session with farmers. In Phase 4, the acceptability, feasibility, and fidelity of these components were identified as the outcome measures for the first trial of the intervention. The four-phase systematic method detailed here constitutes an initial template for developing theory-based, stakeholder-driven, behaviour-change-based interventions targeting farmers and reporting such developments.
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Affiliation(s)
- Aswathi Surendran
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland; (A.S.)
| | - Jennifer McSharry
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland; (A.S.)
| | - Oonagh Meade
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland; (A.S.)
| | - Francis Bligh
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - John McNamara
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - David Meredith
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - Denis O’Hora
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland; (A.S.)
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Cevik C, Ozdemir R, Ari S. How to reduce pesticide exposure in farmers: An intervention study. Work 2023:WOR211380. [PMID: 36683475 DOI: 10.3233/wor-211380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pesticide poisoning is a serious public health problem. OBJECTIVE The aim was to investigate the effect of safe pesticide application training given to farmers on their behaviors towards compliance with protective measures. METHODS In this interventional study, the target population was 9750 farmers living in Turkey. To achieve a study power of 95% , type I error and the effect size were assumed as 5% and 0.50 respectively. In the study, 61 farmers were selected using the systematic sampling method. Farmers were interviewed twice, before and after the training, and at each interview, they were asked questions about their pesticide use-related behaviors in the last four sprayings. In the analysis, the paired t test, repeated measures of ANOVA (post hoc: Bonferroni) were used. RESULTS The scores the participants obtained from the Pesticide Exposure Prevention Behavior Form which questions their compliance with protective measures taken during pesticide applications at the post-interview were significantly higher than were the scores they obtained at the pre-interview (P < 0.001). The analysis of the independent variables demonstrated that the scores obtained from the Pesticide Exposure Prevention Behavior Form at the post-interview were significantly different from those obtained at the pre-interview in almost all of the subgroups in terms of their sociodemographic characteristics. CONCLUSION It was observed that the training given to the farmers on the safe use of pesticides encouraged the farmers to develop positive behavioral changes. The study emphasizes the importance of implementing ongoing health education programs for farmers.
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Affiliation(s)
- Celalettin Cevik
- Department of Public Health Nursing, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey
| | - Raziye Ozdemir
- Department of Midwifery, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Sezgin Ari
- Department of Nursing, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey
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Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review. Int Arch Occup Environ Health 2023; 96:27-44. [PMID: 35838774 DOI: 10.1007/s00420-022-01880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/04/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. METHODS A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. RESULTS Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. CONCLUSION Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.
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Rodriguez-Arrastia M, Martinez-Ortigosa A, Ruiz-Gonzalez C, Ropero-Padilla C, Roman P, Sanchez-Labraca N. Experiences and perceptions of final-year nursing students of using a chatbot in a simulated emergency situation: A qualitative study. J Nurs Manag 2022; 30:3874-3884. [PMID: 35411629 PMCID: PMC10084062 DOI: 10.1111/jonm.13630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022]
Abstract
AIM The aim of this study is to explore the experiences and perceptions of final-year nursing students on the acceptability and feasibility of using a chatbot for clinical decision-making and patient safety. BACKGROUND The effective and inclusive use of new technologies such as conversational agents or chatbots could support nurses in increasing evidence-based care and decreasing low-quality services. METHODS A descriptive qualitative study was used through focus group interviews. The data analysis was conducted using a thematic analysis. RESULTS This study included 114 participants. After our data analysis, two main themes emerged: (i) experiences in the use of a chatbot service for clinical decision-making and and (ii) integrating conversational agents into the organizational safety culture. CONCLUSIONS The findings of our study provide preliminary support for the acceptability and feasibility of adopting SafeBot, a chatbot for clinical decision-making and patient safety. Our results revealed substantial recommendations for refining navigation, layout and content, as well as useful insights to support its acceptance in real nursing practice. IMPLICATIONS FOR NURSING MANAGEMENT Leaders and managers may well see artificial intelligence-based conversational agents like SafeBot as a potential solution in modern nursing practice for effective problem-solving resolution, innovative staffing and nursing care delivery models at the bedside and criteria for measuring and ensure quality and patient safety.
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Affiliation(s)
| | | | - Cristofer Ruiz-Gonzalez
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | | | - Pablo Roman
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Research Group CTS-451 Health Sciences, University of Almeria, Almeria, Spain.,Health Research Centre, University of Almeria, Almeria, Spain
| | - Nuria Sanchez-Labraca
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
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Röösli M, Fuhrimann S, Atuhaire A, Rother HA, Dabrowski J, Eskenazi B, Jørs E, Jepson PC, London L, Naidoo S, Rohlman DS, Saunyama I, van Wendel de Joode B, Adeleye AO, Alagbo OO, Aliaj D, Azanaw J, Beerappa R, Brugger C, Chaiklieng S, Chetty-Mhlanga S, Chitra GA, Dhananjayan V, Ejomah A, Enyoh CE, Galani YJH, Hogarh JN, Ihedioha JN, Ingabire JP, Isgren E, Loko YLE, Maree L, Metou’ou Ernest N, Moda HM, Mubiru E, Mwema MF, Ndagire I, Olutona GO, Otieno P, Paguirigan JM, Quansah R, Ssemugabo C, Solomon S, Sosan MB, Sulaiman MB, Teklu BM, Tongo I, Uyi O, Cueva-Vásquez H, Veludo A, Viglietti P, Dalvie MA. Interventions to Reduce Pesticide Exposure from the Agricultural Sector in Africa: A Workshop Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158973. [PMID: 35897345 PMCID: PMC9330002 DOI: 10.3390/ijerph19158973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/05/2022] [Accepted: 07/19/2022] [Indexed: 12/10/2022]
Abstract
Despite the fact that several cases of unsafe pesticide use among farmers in different parts of Africa have been documented, there is limited evidence regarding which specific interventions are effective in reducing pesticide exposure and associated risks to human health and ecology. The overall goal of the African Pesticide Intervention Project (APsent) study is to better understand ongoing research and public health activities related to interventions in Africa through the implementation of suitable target-specific situations or use contexts. A systematic review of the scientific literature on pesticide intervention studies with a focus on Africa was conducted. This was followed by a qualitative survey among stakeholders involved in pesticide research or management in the African region to learn about barriers to and promoters of successful interventions. The project was concluded with an international workshop in November 2021, where a broad range of topics relevant to occupational and environmental health risks were discussed such as acute poisoning, street pesticides, switching to alternatives, or disposal of empty pesticide containers. Key areas of improvement identified were training on pesticide usage techniques, research on the effectiveness of interventions targeted at exposure reduction and/or behavioral changes, awareness raising, implementation of adequate policies, and enforcement of regulations and processes.
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Affiliation(s)
- Martin Röösli
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; (C.B.); (S.C.-M.); (A.V.)
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
- Correspondence: (M.R.); (S.F.); (M.A.D.)
| | - Samuel Fuhrimann
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; (C.B.); (S.C.-M.); (A.V.)
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
- Correspondence: (M.R.); (S.F.); (M.A.D.)
| | - Aggrey Atuhaire
- Uganda National Association of Community and Occupational Health (UNACOH), YMCA Building, Plot 37/41, Buganda Road, Kampala P.O. BOX 12590, Uganda;
| | - Hanna-Andrea Rother
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa; (H.-A.R.); (L.L.)
| | - James Dabrowski
- Sustainability Research Unit, Nelson Mandela University, P.O. Box 6531, George 6530, South Africa;
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA 94720, USA;
| | - Erik Jørs
- Odense University Hospital, University of Southern Denmark, 5230 Odense, Denmark;
| | - Paul C. Jepson
- Oregon IPM Center, Oregon State University, Corvallis, OR 97331, USA;
| | - Leslie London
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa; (H.-A.R.); (L.L.)
| | - Saloshni Naidoo
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban 4000, South Africa;
| | - Diane S. Rohlman
- College of Public Health, University of Iowa, Iowa City, IA 52242, USA;
| | - Ivy Saunyama
- Food and Agriculture Organization of the United Nations, Subregional Office for Southern Africa, Block 1 Tendeseka Office Park, Eastlea, Harare, Zimbabwe 00153 Rome, Italy;
| | - Berna van Wendel de Joode
- Infants’ Environmental Health Program (ISA), Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional de Costa Rica, Heredia 40101, Costa Rica;
| | - Adeoluwa O. Adeleye
- Department of Crop Production and Protection, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (A.O.A.); (O.O.A.); (M.B.S.)
| | - Oyebanji O. Alagbo
- Department of Crop Production and Protection, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (A.O.A.); (O.O.A.); (M.B.S.)
| | - Dem Aliaj
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland;
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;
| | - Ravichandran Beerappa
- ICMR-Regional Occupational Health Centre (Southern), Bangalore 562110, India; (R.B.); (V.D.)
| | - Curdin Brugger
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; (C.B.); (S.C.-M.); (A.V.)
| | - Sunisa Chaiklieng
- Department of Environmental Health, Occupational Health and Safety, Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Shala Chetty-Mhlanga
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; (C.B.); (S.C.-M.); (A.V.)
| | - Grace A. Chitra
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum 695024, Kerala, India;
| | - Venugopal Dhananjayan
- ICMR-Regional Occupational Health Centre (Southern), Bangalore 562110, India; (R.B.); (V.D.)
| | - Afure Ejomah
- Department of Animal and Environmental Biology, University of Benin, P.M.B. 1154, Benin City 300212, Nigeria; (A.E.); (O.U.)
| | - Christian Ebere Enyoh
- Green and Sustainable Chemical Technologies, Graduate School of Science and Engineering, Saitama University, Saitama 3388570, Japan;
| | - Yamdeu Joseph Hubert Galani
- Section of Natural and Applied Sciences, School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury CT1 1QU, UK;
| | - Jonathan N. Hogarh
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;
| | - Janefrances N. Ihedioha
- Department of Pure and Industrial Chemistry, University of Nigeria, Nsukka 410001, Nigeria; (J.N.I.); (M.B.S.)
| | - Jeanne Priscille Ingabire
- Horticulture Program, Rwanda Agriculture and Animal Resources Development Board, Kigali 5016, Rwanda;
| | - Ellinor Isgren
- Lund University Centre for Sustainability Studies (LUCSUS), P.O. Box 170, SE-221 00 Lund, Sweden;
| | - Yêyinou Laura Estelle Loko
- Ecole Nationale Supérieure des Biosciences et Biotechnologies Appliquées (ENSBBA), Université Nationale des Sciences, Technologies, Ingénierie et Mathématiques (UNSTIM), BP 2282 Abomey, Benin;
| | - Liana Maree
- Department of Medical Bioscience, University of the Western Cape, Bellville 7493, South Africa;
| | - Nkoum Metou’ou Ernest
- Ministry of Agriculture and Rural Development, Cameroon, Direction of Regulation and Quality Control of Agricultural Inputs and Product, Messa, Yaoundé P.O. Box 2082, Cameroon;
| | - Haruna Musa Moda
- Department of Health Professions, Manchester Metropolitan University, Manchester M15 6BG, UK;
| | - Edward Mubiru
- Chemistry Department, School of Physical Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda;
| | - Mwema Felix Mwema
- School of Materials, Energy, Water and Environmental Sciences, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania;
| | - Immaculate Ndagire
- Southern and Eastern Africa Trade Information and Negotiation Institute (SEATINI) Uganda, Kampala P.O. Box 3138, Uganda;
| | - Godwin O. Olutona
- Industrial Chemistry Programme, College of Agriculture Engineering and Science, Bowen University, Iwo 232101, Nigeria;
| | - Peter Otieno
- Pest Control Products Board, Loresho, Nairobi P.O. Box 13794-00800, Kenya;
| | - Jordan M. Paguirigan
- Common Services Laboratory, Food and Drug Administration (FDA) Philippines, Alabang, Muntinlupa 1781, Philippines;
| | - Reginald Quansah
- School of Public Health, University of Ghana, Accra P.O. Box LG13, Ghana;
| | - Charles Ssemugabo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda;
| | - Seruwo Solomon
- CropLife Uganda, Chicken House, Plot1, Old Kampala Road, Second Floor Room 17, Kampala P.O. Box 36592, Uganda;
| | - Mosudi B. Sosan
- Department of Crop Production and Protection, Obafemi Awolowo University, Ile-Ife 220282, Nigeria; (A.O.A.); (O.O.A.); (M.B.S.)
| | - Mohammad Bashir Sulaiman
- Department of Pure and Industrial Chemistry, University of Nigeria, Nsukka 410001, Nigeria; (J.N.I.); (M.B.S.)
| | - Berhan M. Teklu
- Ethiopian Agriculture Authority, Addis Ababa P.O. Box 313003, Ethiopia;
- Faculty of Naval and Ocean Engineering, Istanbul Technical University, Maslak P.O. Box 34469, Turkey
| | - Isioma Tongo
- Laboratory for Ecotoxicology and Environmental Forensics, Department of Animal and Environmental Biology, University of Benin, P.M.B. 1154, Benin City 300212, Nigeria;
| | - Osariyekemwen Uyi
- Department of Animal and Environmental Biology, University of Benin, P.M.B. 1154, Benin City 300212, Nigeria; (A.E.); (O.U.)
- Department of Zoology and Entomology, Faculty of Natural and Agricultural Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Henry Cueva-Vásquez
- Facultad de Ciencias de la Salud, Carrera de Medicina Humana Lima, Universidad Científica del Sur, Lima 15067, Peru;
| | - Adriana Veludo
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; (C.B.); (S.C.-M.); (A.V.)
| | - Paola Viglietti
- Centre for Environmental and Occupational Health (CEOHR), School of Public Health and Family Medicine, University of Cape Town, Cape Town 7700, South Africa;
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health (CEOHR), School of Public Health and Family Medicine, University of Cape Town, Cape Town 7700, South Africa;
- Correspondence: (M.R.); (S.F.); (M.A.D.)
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Rueda-Ruzafa L, Ropero-Padilla C, Ruiz-González C, Rodriguez-Arrastia M, Roman P, Sánchez-Labraca N. A nursing socio-environmental approach for acute pesticide poisoning: A qualitative focus group study. J Adv Nurs 2022; 79:1754-1764. [PMID: 35668553 DOI: 10.1111/jan.15319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/23/2022] [Accepted: 05/07/2022] [Indexed: 12/01/2022]
Abstract
AIM To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario. DESIGN A qualitative descriptive study was conducted using focus groups. METHODS Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used. RESULTS After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies. CONCLUSIONS Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice. IMPACT Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals.
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Affiliation(s)
- Lola Rueda-Ruzafa
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain
| | - Cristofer Ruiz-González
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Torrecardenas University Hospital, Almeria, Spain
| | - Miguel Rodriguez-Arrastia
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Research Group CTS-451 Health Sciences, University of Almeria, Almeria, Spain.,Health Research Centre, University of Almeria, Almeria, Spain
| | - Nuria Sánchez-Labraca
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
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Dhansoia V, Majumdar V, Manjunath NK, Singh Gaharwar U, Singh D. Breathing-Focused Yoga Intervention on Respiratory Decline in Chronically Pesticide-Exposed Farmers: A Randomized Controlled Trial. Front Med (Lausanne) 2022; 9:807612. [PMID: 35372380 PMCID: PMC8965718 DOI: 10.3389/fmed.2022.807612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Occupational exposure to pesticides has been associated with lung and cognitive function exacerbations. In the present study, we tested the effectiveness of breathing focused yoga intervention on alleviation of adverse respiratory and cognitive effects associated with chronic pesticide exposure in farmers. Methods We undertook a parallel, two-armed randomized controlled trial with blinded outcome assessors on a chronically pesticide-exposed farming population. The study was conducted at district Panipat, State Haryana located in the Northern part of India from November 2019 to August 2020. A total of 634 farmers were screened, and 140 farmers were randomized to breathing-focused yoga intervention (BFY, n = 70) and waitlist control arms (n = 65). BFY was delivered weekly in 45-min group sessions over 12 weeks followed by home-based practice. The primary outcome was the change in spirometry-based markers of pulmonary function from baseline expressed as raw values, Global Lung Initiative (GLI) percent predicted (pp), and GLI z-scores after 24 weeks of intervention. Secondary variables were Trail making tests (TMT A and B), Digit symbol substitution (DSST), and WHO Quality of life-BREF (WHOQOL-Bref). Analysis was by intention-to-treat. Mediation analysis was done considering oxidative stress markers as potential mediators. Results At the end of 6 months of intervention, the overall follow-up in the participants was 87.85% (n = 123); 90% (n = 63) in the control group, and 85.71% in the yoga group (n = 60). The mean age of the study cohort (n = 140) was 38.75 (SD = 7.50) years. Compared with the control group, at 24 weeks post-intervention, the BFY group had significantly improved status of the raw sand z scores markers of airway obstruction, after adjusting for confounders, FEV1, FVC, FEF25-75 [z score-adjusted mean differences (95% CI); 1.66 (1.10-2.21) 1.88 (1.21-2.55), and 6.85 (5.12-8.57), respectively. A fraction of FEF25-75 change (mediation percentage 23.95%) was explained by glutathione augmentation. There were also significant improvements in cognitive scores of DSST, TMT-A and TMT-B, and WHOQOL-Bref. Conclusion In conclusion, regular practice of BFY could improve the exacerbations in the markers of airway obstruction in chronically pesticide-exposed farmers and cognitive variables. A significant mediating effect of glutathione augmentation was also observed concerning the effect of the intervention on FEF25-75. These findings provide an important piece of beneficial evidence of the breathing-based yoga intervention that needs validation across different farming ethnicities.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: CTRI/2019/11/021989.
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Affiliation(s)
- Vipin Dhansoia
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Vijaya Majumdar
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - N. K. Manjunath
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Usha Singh Gaharwar
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi, India
- Swami Shraddhanand College, University of Delhi, Alipur, Delhi
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The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis. Int Arch Occup Environ Health 2022; 95:1167-1178. [PMID: 35103845 DOI: 10.1007/s00420-022-01838-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/12/2022] [Indexed: 11/05/2022]
Abstract
AIM The aim of this study was to determine the effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure. METHOD All studies published in the English language between the years 2000 and 2020 were screened on relevant databases. The study protocol was registered on PROSPERO. Randomised controlled studies (RCTs) and quasi-experimental studies meeting the inclusion and exclusion criteria according to the PICOS criteria were included. In line with the PRISMA flow diagram, 38 studies were included in the systematic review and meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias assessment tool. A random-effects model was applied and Hedge's g was used to calculate effect size. FINDINGS Five of the included studies are RCTs, two are cluster RCTs, 17 are quasi-experimental studies with experimental and control groups, and 14 have single-group pretest-posttest study designs. Educational interventions had a large effect on knowledge level (Hedge's g = 0.890), a medium effect on behaviour level (Hedge's g = 0.707), and a small effect on risk perception (Hedge's g = 0.377). No publication bias was detected. The largest effect of educational interventions on both knowledge and behaviour levels belonged to studies grounded on a theoretical basis and carried out between the years 2011 and 2020. CONCLUSION It was determined that educational interventions are an appropriate method for reducing the pesticide exposure risks of agricultural workers. To increase the effectiveness of these interventions, it is recommended that consideration is given to a theoretical basis, the use of multiple education components, and evidence-based practices.
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The Increase in Frequency of Protective Behavior against Pesticide Poisoning in Narail, Bangladesh through Use of an Easy Paper Checklist; an Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179349. [PMID: 34501938 PMCID: PMC8431624 DOI: 10.3390/ijerph18179349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022]
Abstract
Protecting the health of farmworkers is a crucial issue. Previous studies report that safety training and educational interventions might increase farmworkers’ protective behaviors. The present study aimed to investigate the effectiveness of distributing a checklist as an interventional measure for pesticide protection in rural Asia, where pesticide poisoning is a major problem. This study was a community-based interventional study, using the distribution of a checklist with pesticide protective habits in Narail district, Bangladesh, with a total of 100 eligible males. Two questionnaire surveys were conducted before distributing the checklist and 25 days after. Change between the baseline and follow-up surveys was measured by frequency scores of protective behavior. The average pesticide-protective behavioral score increased from 4.58 in the baseline survey to 8.11 in the follow-up. Additionally, the checklist was more effective in the group with higher education, the younger group, and the group with lower pesticide-protective behavioral scores in the baseline survey. The paper checklist on protective behaviors against pesticide poisoning was effective because of the increase in the frequency of such positive behavior among farmworkers. Thus, intervention measures should be implemented to increase the knowledge and awareness regarding pesticide protection habits to protect the health of farmworkers.
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